Acute medicine is a specialty within internal medicine concerned with the immediate and early specialist management of adult patients with a wide range of medical conditions who present in hospital as

emergencies An emergency is an urgent, unexpected, and usually dangerous situation that poses an immediate risk to health, life, property, or environment and requires immediate action. Most emergencies require urgent intervention to prevent a worsening ...

. It developed in the

United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...

in the early 2000s as a dedicated field of medicine, together with the establishment of acute medical units in numerous hospitals. Acute medicine is distinct from the broader field of

emergency medicine Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unsche ...

, which is concerned with the management of all people attending the

emergency department An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...

, not just those with internal medicine diagnoses.

History

The field developed in the

after the

Royal College of Physicians of Edinburgh The Royal College of Physicians of Edinburgh (RCPE) is a medical royal college in Scotland. It is one of three organisations that sets the specialty training standards for physicians in the United Kingdom. It was established by Royal charter ...

and the

Royal College of Physicians and Surgeons of Glasgow The Royal College of Physicians and Surgeons of Glasgow, is an institute of physicians and surgeons in Glasgow, Scotland. Founded by Peter Lowe after receiving a royal charter by James VI in 1599, as the Glasgow Faculty, it originally exis ...

published a joint report in 1998 emphasising the importance of appropriate care for people with acute medical problems. Further reports led to the development of acute medicine as a dedicated specialty, and in 2003 it was recognised by the Specialist Training Authority as a subspecialty of General Internal Medicine. Around the same time, it was recognised that care for acutely admitted patients should ideally be concentrated in "medical assessment units" (MAUs), later named "acute medical units" (AMUs). A physician experienced in the management of acute medical problems could assess and treat these patients in the most appropriate fashion for the first 48 hours of their admission, aiming either for an early discharge with appropriate outpatient follow-up or transfer to a specialist ward. Severely ill patients who need close observation but do not require

intensive care Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes pro ...

may be treated in a dedicated area such as a physician-run

high-dependency unit A high-dependency unit is an area in a hospital, usually located close to the intensive care unit, where patients can be cared for more extensively than on a normal ward, but not to the point of intensive care. It is appropriate for patients who h ...

. In 2007, some questioned whether the specialty would have a long-term future, if at some point UK government ED targets ceased to exist. However,

Robert Wachter Robert M. "Bob" Wachter is an academic physician and author. He is on the faculty of University of California, San Francisco, where he is chairman of the Department of Medicine, the Lynne and Marc Benioff Endowed Chair in Hospital Medicine, and ...

has stated that acute medical units "have been associated with lower inpatient mortality, improved patient and staff satisfaction, reduced hospital stays, and increased throughput." A further development has been the increase of ''ambulatory care''. Where patients were previously admitted to hospital, it may now be possible for them to attend a clinic or an assessment area a number of times while their progress is monitored. This is now a very common approach to suspected

deep vein thrombosis Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enla ...

, but the

NHS Institute for Innovation and Improvement The NHS Institute for Innovation and Improvement (NHS Institute) was a special health authority of the National Health Service in England. It supported "the NHS to transform healthcare for patients and the public by rapidly developing and sprea ...

has identified a number of other conditions that can be managed in an ambulatory emergency care setting. In 2009, the

General Medical Council The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...

approved acute medicine as a distinct specialty, allowing doctors to specialise in it in order to receive their

Certificate of Completion of Training The Certificate of Completion of Training (CCT) is the certificate that medical doctors in the United Kingdom receive to indicate that they have completed training in their chosen specialty and are therefore eligible for entry onto the specialis ...

Organisations

The Society for Acute Medicine was founded in 2000. It is "the national representative body for staff caring for medical patients in the acute hospital setting. In the Netherlands, the Dutch Acute Medicine (DAM) society was formed in 2012 and held its first Congress on 28 September 2012 in the

VU University Medical Center VU University Medical Center Amsterdam ( nl, VU Medisch Centrum or VUmc) is the university hospital affiliated with the Vrije Universiteit Amsterdam. It is rated one of the best academic medical centers in the country in terms of patient care and ...

in Amsterdam. Its curriculum aimed to ensure 12 training posts throughout the Netherlands.

References

External links

Society for Acute Medicine

Acutemed.co.uk

Acute Internal Medicine - West Midlands
__notoc__ {{DEFAULTSORT:Acute medicine Healthcare in the United Kingdom